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Mental Health, Gun Debates Need Healthcare Voices


Physicians, physician assistants, and other providers should be at the forefront of the debates stemming from the Newtown shootings locally and nationally.

No one in America, parents or not, could help but be profoundly affected by the massacre of innocent, children and teachers at Sandy Hook Elementary School. I watched, stunned, with colleagues in our medical staff lounge as this horrific drama played itself out on TV.

I must confess that I have become increasingly numb to the violence we now see everywhere in our society. As medical providers, we see it in our personal and professional lives often. But we must never let it become routine.

I’m certainly exposed to a daily diet of the result of violence at my facility. Nearly all healthcare providers confront societal violence in their practices on a regular basis. But, any numbness I might have felt, or thought that I might have had about yet “another” senseless act of violence, quickly vanished at the site of the most vulnerable among us dying at the hands of a madman.

Our local paper’s editorial page has been full of prescriptions for the resolution of this problem from both sides of the violence/gun control debate. One writer opined that we should arm teachers and principals in our schools to “defend” against this kind of senseless slaughter. The “solution” to this problem is not a society where everyone is armed to protect against violence. The solution is a less violent, and healthy society. We have to ask ourselves rationally, and intelligently, what is the rest of the modern world doing that is better than what we are doing?

This is where we come in. Physicians, physician assistants, and other healthcare providers should be at the forefront of this debate in our communities, and in our nation. We see violence and murder firsthand and daily in many of our practices, and we have to change the course of gun violence, mental illness, and healthcare in our communities. Our survival as a society and as a democracy is at stake in this debate.

This issue has brought to light the lack of mental health infrastructure in our country. Those of us in the healthcare field are daily painfully reminded of this fact as we try to help our patients with mental illness. That notwithstanding, can we all agree with the premise that mentally ill individuals should not have access to firearms under any circumstances?

People play fast and loose with statistics on this emotional issue. The fact is that the U.S. is not the worst in the world when it comes to gun violence and murder by firearms. Yet, there is a much different picture when you compare our nation to other modern, industrialized, affluent countries.

According to U.N. figures, the U.S. had 9,146 homicides by firearm in 2009. That year, Colombia and Venezuela both exceeded the U.S. total, with 12,808 and 11,115 firearm deaths, respectively. Three other nations topped the U.S. amount in the most recent year for which data is available: Brazil (34,678 in 2008), Mexico (11,309 in 2010), and Thailand (20,032 in 2000).

One 2011 study paints a different picture as you dig deeper into the demographics. The study, published in the Journal of Trauma - Injury Infection & Critical Care, found that firearm homicide rates were 19.5 times higher in the U.S. than in 23 other "high income" countries studied, using 2003 data. Rates for other types of gun deaths were also higher in the U.S., but by somewhat smaller margins: 5.8 times higher for firearm suicides (even though overall suicide rates were 30 percent lower in the U.S.) and 5.2 times higher for unintentional firearm deaths.

Why are we so much more “violent” than other, like-affluent countries in the world? I don’t have any easy answers. However, part of it has to do with our fascination with gun “freedom,” and equating this with the right to buy rapid fire weapons of any type, oversized magazines, etc., when these only serve to kill people faster, and in greater numbers. As William Saletan said in his recent Slate editorial, “The faster the weapon, the higher the body counts. It’s not politics; its logistics.”

How many more Sandy Hooks do we have to endure to galvanize us into action? None for me.

This blog was provided in partnership with the American Academy of Physician Assistants.

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